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There are theoretical reasons to believe that radiotherapy (RT) given in larger fractions during a shorter period of time might result in more late side effects than giving a conventional, more protracted RT in patients with rectal cancer. In addition, the optimum timing of surgery after RT, with respect to postoperative morbidity, mortality and potential downsizing of the tumour is not known.

To address these questions, a prospective randomized multicentre trial was initiated, the Stockholm III trial, in which patients with primarily resectable rectal cancer were randomized to short-course preoperative RT (5x5 Gy) followed by surgery within one week or after 4-8 weeks or long-course preoperative RT(25x2 Gy) followed by surgery after 4-8 weeks.

Condition or disease

Intervention/treatment

Phase

Rectal Cancer

Radiation: Preoperative radiotherapy

Phase 2Phase 3

Detailed Description:

Preoperative radiotherapy (RT) is recommended to many patients with localised rectal cancer, not previously treated with pelvic RT. However, the optimum fractionation, the timing of surgery and the best use of concomitant chemotherapy remains controversial. Short-course, preoperative RT may induce both acute and late morbidity and has been claimed to cause more morbidity than long-course preoperative RT. There are theoretical reasons to believe that RT given in larger fractions during a shorter period of time might result in more late side effects than giving a conventional, more protracted RT. In addition, the optimum timing of surgery after RT, with respect to postoperative morbidity, mortality and potential downsizing of the tumour is not known.

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